21 March 2019 What is a digestive echo-endoscopy? A digestive echo-endoscopy combines endoscopy and echography to view structures in the digestive tract. It allows us to view the: Lining of the oesophagus; Stomach; Duodenum; Sigmoid colon; Rectum. As well as some organs neighbouring the digestive tract: Pancreas; Bile ducts; Mediastinum; Pelvic cavity. How is a digestive echo-endoscopy carried out? A digestive echo-endoscopy is performed with the patient lying down. A long, flexible tube called an echoendoscope is inserted via the mouth (upper digestive echo-endoscopy) or the anus (lower digestive echo-endoscopy). The tube is fitted with an ultrasound probe and a video camera. The probe transmits enlarged, high definition endoscopic and ultrasound images to a monitor in the exam room. This enables viewing of the ultrasound images from inside the digestive tract to assess the entire thickness of the digestive region walls travelled by the echo-endoscope and also some neighbouring organs. Echo-endoscopy is also able to detect alterations other techniques cannot pick up. An echo-endoscopy also has components that enable us to: Painlessly collect tissue samples (biopsy); Insert or remove air, fluids and instruments used in any necessary procedures. The progress of the echo-endoscopy through the digestive system may cause some discomfort. Upper digestive echo-endoscopies are therefore usually performed with anaesthetic . On the other hand, lower digestive echo-endoscopies do not usually involve anaesthetic or sedation. An anaesthetic or sedation may be necessary in individual cases, however. In specific cases prophylactic antibiotics may be administered. Neither sedation nor anaesthetic require hospital admission . Normally, recovery requires a 30-minute rest period , after which the patient can be discharged. Patients are advised to be accompanied by someone who can provide assistance after the exam if necessary on the day of the exam. In some specific cases, patients may be admitted to hospital for an echo-endoscopy. When is a digestive echo-endoscopy carried out? It is always for the doctor to decide whether there is a need for a particular test, depending on the individual characteristics of each patient and their specific complaints or illness . An echo-endoscopy may be performed for diagnosis and/or treatment . As a rule, it is performed after other exams, to clarify findings or perform certain treatments. Indications for echo-endoscopies include: Diagnosis, staging and assessment of the extent of neoplasms; Early detection of returning tumours; Diagnosis of other lesions or diseases of the digestive wall and neighbouring organs; Performance of biopsies under ultrasound control. An echo-endoscopy is currently considered a particularly valuable technique in the diagnosis and some treatments in the digestive tract. How long does an echo-endoscopy take? The duration of an echo-endoscopy varies considerably, depending on its purpose. It usually lasts between 15 minutes and 1 hour. After the exam is complete, patients must wait a while until they have fully recovered. This time should be spent resting in a designated area. The patient may then leave the hospital. Although an echo-endoscopy is not a lengthy examination, the patient is advised to set aside a morning or afternoon for the scan , given that it may be carried out under sedation or anaesthetic or that it may cause discomfort if it is not. What are the limitations of an echo-endoscopy? Echo-endoscopy is a technique that can miss lesions and diagnoses , even when the examination is carried out correctly. There are a number of imaging scans that can also help obtain relevant information (e.g. CT). However, these exams provide additional information but cannot fully replace an echo-endoscopy. Ask your doctor about the matter and also ask the physician performing the scan if you have any further questions. At the hospitals and clinics of the Hospital da Luz network, there are gastroenterologists who specialise in the diagnosis and treatment of digestive diseases and who can perform the necessary examinations for your condition. Are there any side effects, risks or complications associated with an echo-endoscopy? The effects of the anaesthetic generally disappear after a few hours. The possible insertion of air may result in flatulence and abdominal pressure for a few hours. The risks from an echo-endoscopy are rare, but they exist, as with any other examination in which devices or medicinal products are used. The incidence of these risks varies in accordance with each individual case and depends on any drugs or additional procedures that may be necessary. To reduce the risk of complications it is essential to inform the doctor of: Allergies; Other pre-existing conditions; Current treatments. Possible risks and complications include: Bruising of the vein used to administer drugs; Allergic reactions to drugs; Difficulty breathing; Alteration of blood pressure or heart rate due to drugs administered; Pneumonia due to aspiration of stomach content; Perforation (usually requiring hospital admittance and possible surgery). One case is estimated to occur in every 3,000 procedures. If it is necessary to dilate the digestive tract, one case is estimated to occur in every 50 procedures. There are also possible complications associated with procedures performed during the exam: Complications of ultrasound-guided biopsies Infection: <1%; Pancreatitis (inflammation of the pancreas): 0%-2%; Bleeding: 1%; Peritonitis (severe inflammation of the abdomen): <1%. Complications of celiac plexus neurolysis: Transient diarrhoea: 4%-15%; Fall in blood pressure: 1%; Transient increase in pain: 9%; Infection or abscess: <1%. Complication of pseudocyst drainage: 11%-37% Bleeding; Perforation; Infection; Prosthesis migration. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
